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General Anatomy > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

1st heart sound:

A

Caused by tricuspid & bicuspid valves (AV valve closure)

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2
Q

2nd heart sound

A

Caused by closure of pulmonary and aortic valves (semilunar valves)

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3
Q

3rd heart sound

A
  • Heard only among children and young adults
  • Best heard when ask patient to lie on left side
  • Disappears in 30’s
  • If present in older adults may signify heart failure @ Erb’s point or mitrovalve area
  • Caused by ventricular filling
  • Vibration of ventricles
  • Blood rushing from atria to ventricles
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4
Q

4th heart sound:

A
  • Heard after 1st heart sound

- Heard in people w/ heart disease or MI

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5
Q

Projection Areas of Valve Sound:

  • Pulmonic:
  • Aortic:
  • Tricuspid:
  • Mitral:
  • Erb’s point:
A
  • 2nd left intercostal space lateral to sternum
  • 2nd right intercostal space lateral to sternum
  • over lower portion of sternum
  • 5th left intercostal ½ inch medial to the midclavicular line
  • S2 sound- in 3rd left intercostal space
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6
Q

Mapping out the Heart:
-Superior border:

  • Right border:
  • Inferior border:
  • Left border:
A

– a line connecting the inferior margin of the 2nd left costal cartilage and superior margin of 3rd right costal cartilage

  • line connecting 3rd right costal cartilage to 6th right costal cartilage
  • line connecting 6th right costal cartilage to apex beat are (3.5inches from midline at left 5th intercostal space)
  • connects left ends of superior and inferior border
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7
Q

Nerve Supply of the Heart

Cardiac Plexus of Nerves Contain:

A
  • Preganglionic parasympathetic fibers (vagus nerve)
  • Vagal afferent fibers-concerned with cardiac reflexes
  • Postganglionic sympathetic fibers (T1-T4/5)
  • Sympathetic afferent fibers-detects ischemic pain
  • NOT sensitive to touch, cutting, cold, or heat
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8
Q

Cardiac Conduction System:

SA node:

A

SA node:

  • Superior end of sulcus terminalis
  • In subepicardium (under epicardium)
  • Near opening of SVC
  • Natural pacemaker of the heart
  • 70-80bpm
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9
Q

AV node:

A
  • If SA node is damaged or destroyed AV node takes over as the pacemaker
  • Provides impulses 40-60bpm
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10
Q

Purkinje fibers

A

-Ends in sub-endocardium

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11
Q

FUN FACTS CLINICALLY

A
  • IF SA node & AV node are both damaged- will have multiple pacemakers= ventricular fibrillation- heart quivers =doesn’t pump efficiently-must force multiple pacemakers to synchronize.
  • Transplant=DENERVATED- no more nerve supply from the vagus nerve or sympathetic nervous system-when exercise doesn’t pump any harder= DELAYED RESPONSE; when resting, then starts to increase through adrenal glands= LONG DURATION
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12
Q

“SKELETON OF THE HEART”

A

Composed of fibrous or fibrocartilaginous tissue
-Forms the central support of the heart

  • Fibrous rings that give circular form and rigidity to
  • the AV orifices and roots of pulmonary trunk and aorta
  • Provide attachment to valves and prevent the outlets from becoming dilated
  • Also provides attachment to cardiac muscle fibers
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13
Q

Venus Drainage:

Coronary Sinus:

  • Anterior Cardiac Veins: drain directly to RA
  • Vena Cordis minimi: drains directly into atria
A
  • Great cardiac vein-accompanied by anterior interventricular artery
  • Middle cardiac vein- accompanied by posterior interventricular artery
  • Small cardiac vein-accompanied by right marginal artery
  • Left marginal vein-accompanied by left marginal artery
  • Left posterior interventricular vein-accompanied by left posterior ventricular artery
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14
Q

Right Coronary Artery:

A

RA & RV

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15
Q

Circumflex-

A

LA and LV

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16
Q

Pericardium:

A
  • Located in the middle mediastinum
  • Posterior to the body of the sternum
  • 2nd-6th costal cartilages
  • Anterior to T5-T8 vertebrae
  • Double-walled fibrous sac which encloses the heart and root of the great vessels: conical in shape
  • It is bound by pericardiacophrenic and sternopericardial ligaments
  • Cavity contains 5-30ml of serous fluid
  • Arterial supply: branches from the internal thoracic, pericardiacophrenic, musculophrenic, and inferior Phrenic arteries, and the thoracic aorta
  • Nerve supply: phrenic and vagus nerves, sympathetic trunks
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17
Q

Fibrous and serous pericardium

A

Fibrous pericardium: outer tough fibrous layer made up of dense irregular CT
o Serous pericardium: parietal layer and visceral layer (epicardium)

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18
Q

Pericarditis:

A

inflammation of the pericardium; causes increased secretion of serous fluid-surface becomes rough

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19
Q

Pericardial effusion:

A

increased secretion of fluid-due to infection

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20
Q

Cardiac tamponade

A

blood coming out to sac but still in pericardium-starts to compress the heart and therefore compression of great vessels especially SVC

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21
Q

Pericardiocentesis:

A

put needle into pericardium then extract

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22
Q

External Features of the heart:

A
  • Pyramidal shape; fibrous framework
  • External sufaces: sternocostal, diaphragmatic, & pulmonary; a base; apex
  • Coronary sulcus: groove that separates atria from ventricles (aka AV sulcus)
  • Interventricular sulcus: b/w ventricles
  • Sulcus terminalis: along inferior/superior vena cava (right side) – inside is crista terminalis
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23
Q

Coronary arteries and branches

A
  • RCA: marginal and posterior interventricular arteries

- LCA: anterior interventricular and circumflex arteries

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24
Q

Coronary sinus and cardiac veins

A
  • Posterior cardiac veins drain directly into coronary sinus
  • Anterior cardiac veins drain directly into RA
  • Coronary sinus drains into RA
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25
Q

Surfaces of the Heart:

  • Anterior or sternocostal surface
  • Left pulmonary surface:
  • Right pulmonary surface:
  • Inferior or diaphragmatic surface:
  • Base:
  • Apex:
A
  • : is formed mainly by the RV
  • faces left lung and consists of the LV and part of the LA
  • faces the right lung and consists of the RA
  • is formed by the LV and partly by the RV; it is closely related to the central tend on of the diaphram
  • is the posterior aspect of the heart formed mainly by the LA facing the bodies of T6-T9 vertebra
  • is located in the left 5th ICS at the MCL and is formed by the inferolateral part of the LV
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26
Q

Borders of the Heart:

  • Superior: formed by
  • Inferior: formed by the
  • Left: formed mainly by
  • Right border: formed by
A
  • LA and RA and auricles
  • RV and slightly by the LV
  • LV and partly by left auricle
  • RA and extends from SVC to IVC
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27
Q

Internal Features of the Heart:

RA:

A 
crista terminalis
	sinus venarum
	pectinate muscles
	venous openings
	fossa ovalis
	tricuspid orfice
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28
Q

LA:

A

Pulmonary vein openings

Mitral orifice

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29
Q

RV:

A
  • Conus arteriosus (infundibulum)
  • Paillary
  • Traveculae carnae
  • Moderator band
  • Chordae tendineae
  • tricuspid valve
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30
Q

trachea

A
  • fibroelastic wall with U shaped bars of hyaline cartilage
  • begins at C6 below cricoid cartilage
  • ends at sternal angle between T4 and T5
  • on deep inspiration T6
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31
Q

4 parts of parital Pleura

A
  • Costal
  • Mediastinal
  • Diaphragmatic
  • cervical
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32
Q

2 pleural recesses

A

Costodiaphragmatic (down by diaphragm)

costomediastinal

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33
Q

contents of the hilum of the lung

A

a pulmonary artery
two pulmonary veins
a main bronchus
bronchial vessels

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34
Q

right lung has 3 lobes

A

superior, middle and inferior

superior and middle seperated by horizontal fissure

middle lobe and inferior lobe seperated by oblique fissure.

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35
Q

left lung has two lobes

A

the superior and the inferior

seperated by the oblique fissure

the lingula is a remnant of the middle lobe

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36
Q

grooves found in the left lung

A

arch of the aorta, cardiac impression, descending aorta, groove for subclavian

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37
Q

grooves for right lung

A

groove for superior vena cava, groove for azygos vein, groove for esophagus

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38
Q

primary bronchi (how do you tell them apart)

A

right side is wider, shorter and more vertical

left is longer, thinner and more transverse

the two bifricate from the carina

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39
Q

ligamentum arteriosum

A

ligament that connects the arch of the aorta to the pulmonary artery

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40
Q

sympathetc (for lungs)

A

thoracic splanchnic

bronchodialation
decreased bronchial gland secretion
vasoconstriction

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41
Q

parasympathetic (lungs)

A

Vagus

bronchoconstriction
increased bronchial gland secretion
mild to no vasodialation

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42
Q

the Diaphragm

A

boundary between thoracic and abdominal cavities

higher on the right than on the left due to the right lobe of the liver
origin: sternal portion: back of xiphoid process
costal portion- inner surface of lower 6 rib cartilage
vertebral portion- arcuate ligaments and upper lumbar vertebrae

Insertion- central tendon

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43
Q

openings in diaphragm

caval

esophageal

aortic

A
  • T8- IVC right phrenic nerve
  • T10- esophagus, vagal trunks, left gastric vessels
  • T12- aorta, thoracic duct, azygos/hemiazygos
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44
Q

nerve supply to diaphragm

A

phrenic, GSE, motor supply for whole diaphragm and sensory supply for central

sensory to the peripheral part of diaphragm is by lower intercostal nerves and the convey GSA, GSE, GVA

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45
Q

Which of the following arteries run along the lesser curvature of the stomach?

A

right gastric

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46
Q

Which of the following structural landmarks is used to delineate the fundus from the body of the stomach?

A

cardiac notch

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47
Q

Which vessel runs along the superior border of the pancreas?

A

splenic artery

48
Q

The main pancreatic duct joins the common bile duct as it enters the second part of the duodenum, forming a common tiny space called the:

A

hepatopancreatic ampula

49
Q

n which abdominal region is the spleen located?

A

left hypochondriac

50
Q

Which of the following statements is TRUE regarding the spleen?

A

its located DEEP to ribs 9-11

51
Q

Which of the following statements is TRUE regarding the small intestine?

A

Aggregates of lymphoid nodules called Peyer’s patches are located in the ileum

52
Q

Which of the following statements are TRUE regarding the small intestine

A

The mesenteric attachment of the ileum is located to the right of the aorta.

53
Q

The sigmoid colon extends from the ____________ to the ____________.

A

pelvic inlet to s3 level

54
Q

The three bands of longitudinal muscles found in most of the large intestine are called:

A

tenia coli

55
Q

The parietal peritoneum receives sensory innervation via

A

GSA fibers to spinal levels T7-L1

56
Q

Which type of peritoneal extension connects the stomach to another viscus or to the abdominal wall?

A

Omentum

57
Q

Which of the following structures is considered an intraperitoneal organ?structure?

A

jejunum

58
Q

The greater omentum attaches from the greater curvature of the stomach to the which of the following structures?

A

transverse colon

59
Q

Which of the following structures is NOT contained within the the hepatoduodenal ligament?

A

hepatic vein

60
Q

Which of the following is the embryonic remnant of the umbilical vein?

A

ligamentum teres

61
Q

Which of the following structures is located between the right lobe and the caudate lobe of the liver?

A

Inferior Vena Cava

62
Q

A patient has liver cirrhosis with portal vein hypertension. PE findings show caput medusae. Which portocaval anastomosis is affected in this condition?

A

paraumbilical veins with superficial epigastric veins

63
Q

Which of the following types of nerve fibers is NOT a component of the celiac plexus?

A

postganglionic parasympathetic fibers

64
Q

Which of the following is a function of the gallbladder?

A

concentrates bile

65
Q

Congenital heart disease is the most common cardiac condition in childhood and most frequently results from:

A

multifactorial inheritance

66
Q

The most common congenital defect of the heart and great vessels associated with congenital rubella syndrome is:

A

patent ductus arteriosus

67
Q

A female infant has congestive heart failure and was diagnosed to have patent ductus arteriosus. Which of the following statements is correct?

A

In the fetus, most of the blood from the pulmonary trunk flows into the aorta.

68
Q

Sufficient amount of surfactant is produced during which period of lung development?

A

Terminal Saccular Period (26 weeks to birth)

69
Q

Which transverse body plane passes through the body midway between the jugular notch and the symphysis pubis?

A

transpyloric plane

70
Q

McBurney’s point is located:

A

along a line drawn between the umbilicus and the right ASIS

71
Q

Which ligament attaches to the ASIS and pubic tubercle?

A

inguinal ligament

72
Q

Which of the following marks the inferior edge of the posterior rectus sheath?

A

arcuate line

73
Q

Which structure forms the floor of the inguinal canal?

A

inguinal ligament

74
Q

Which of the following forms the medial boundary of the inguinal triangle?

A

semilunar line

75
Q

Which of the following external features of the heart is located between the two atria and two ventricles?

A

coronary sulcus

76
Q

The apex of the heart lies beneath which surface landmark

A

fifth left ICS at MCL

77
Q

Which of the following is located only in the right ventricle?

A

conus arteriosus

78
Q

During a heart transplant, which of the following nerve fibers can not possibly be cut by a scalpel?

A

preganglionic sympathetic fibers

79
Q

When viewing the cardiac silhouette in a chest x-ray, the inferior border of the cardiac silhouette is formed mostly by which structure?

A

right ventricle

80
Q

During deep inspiration, the trachea can extend all the way down to which vertebral level

A

T6

81
Q

At the posterior chest wall, the right oblique fissure of the lung is located at the level of which bony landmark?

A

SP of T4

82
Q

The horizontal fissure of the right lung ends anteriorly at which surface landmark?

A

fourth ICS

83
Q

Which structure forms an impression on the mediastinal suface of the left lung?

A

arch of aorta

84
Q

The tertiary bronchi are also know as the ___________.

A

segmental bronchi

85
Q

9 quadrants of body

A

right/ left hypochondrium, epigastric (in middle top)

right/left flank, umbilical in center

right/left groin pubic region in center

86
Q

murpheys point

A

location of the gall bladder

intersection of costal margin and right mid clavicular line

87
Q

McBurney’s point

A

location of appendix

line from ASIS to belly button medial 2/3, lateral 1/3

88
Q

rectus sheath:

above umbilicus

below umbilicus

A
  • above theres a posterior and anterior rectus sheath
  • below theres only anterior rectus sheath
  • arcurate line marks inf. edge of rectus sheath
89
Q

Valsalva’s maneuver

A

holding breathe to increase inter abdominal pressure to aid in taking a shit

90
Q

Umbilical folds:

Lateral

Medial

Median

A
  • lateral formed by inferior epigastric vein & a.a.
  • Medial formed by remnants of umbilical arteries
  • median formed by remnant of urachus
91
Q

the inguinal canal (boundaries)

A

floor- inguinal ligament
roof- internal oblique and transverse abdominis
anterior- aponeurosis of external oblique
posterior wall- transversalis fascia

92
Q

what passes through the inguinal canal

A

spermatic chord and ilioinguinal ligament

females= round ligament of uterus and ilioinguinal nerve

93
Q

development of the inguinal canal

A

peritoneum- process vaginalis, tunica vaginalis

transversalis fascia- internal spermatic fascia

internal oblique M.-cremasteric fascia

external oblique aponeurosis- external spermatic fascia

94
Q

failure of process vaginalis to close results in

A

an indirect inguinal hernia

95
Q

3 layers that cover the spermatic cord

A

external spermatic fascia, cremasteric fascia and internal spermatic fascia

96
Q

cryptorchidism

A

failure of testes to descend, results in infertility and testicular cancer

97
Q

contents of spermatic cord

A

vas deferens,
testicular, deferential, and cremasteric a.a.
pampiniform plexus of veins
genital branch of the genitofemoral nerve GSE/GSA
autonomic and sensory nerves
lymph vessels
remnants of process vaginalis

98
Q

dartos muscle

A

wrinkling of balls due to cold or sexual excitation

99
Q

cremasteric muscles

A

draws balls up towards body

the reflex test is done by stroking inner thigh and seeing if balls do rise

100
Q

borders of inguinal triangle

aka hesselbach’s triangle

A 
lateral= inferior epigastric vessels
medial= rectus abdominis
inferior= inguinal ligament
101
Q

Parietal peritoneum

visceral peritoneum

A

lines the walls of the cavities (GSA from T7-11)

covers the organs (GVA)

102
Q

mesentary

A

double layer of peritoneum that connects an INTROPERITONEAL ORGAN TO THE BODY

103
Q

peritoneal ligament

A

organ to organ

104
Q

omentum

A

stomach to another viscus or to abdominal wall

105
Q

introperitoneal

rectoperitoneal

A
  • organ is covered by peritoneum
    (stomach,liver, spleen, gallbaldder)
  • organ which is partially or not covered by peritoneum
    (kidneys, IVC,pancreas(besides tail),)
106
Q

greater omentum

lesser omentum

A

greater curvature of stomach to transverse colon

lesser curvature of stomach to liver

107
Q

portal triad

A

Common Heptaic a.a.
Hepatic portal vein
common bile duct

108
Q

foramen of winslow

aka epiploic foramen

A

superior- caudate lobe of liver
anterior- hepatoduodenal ligament
inferior- 1st part of duodenum
posterior- IVC

109
Q

portal vein

A

splenic and superior mesenteric make up the portal vein

110
Q

caput medussa

A

dialation of superficial epigastric veins

111
Q

Nerve deal for liver

A

Preganglionic parasympathetic= Vagus

Postganglionic sympathetic=celliac ganglion

GVA fibers

112
Q

common bile duct is composed of

A

cystic duct and common hepatic duct

113
Q

hepatomegaly

A

enlargment of the liver

114
Q

jaundice

A

yellowish discoloration of skin due to hyperbilirubinemia

115
Q

alcoholic cirrhosis

A

destruction of hepatocytes and replacment by fibirous tissue, usualy leads to portal hypertension

116
Q

cholelithiasis or gallstones

A

crystalization of biles salts and cholesterol

General Anatomy (1 decks)

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